Creatine for gut health / crohns / ileitis / ulcerative colitis ? - interesting case report on 1g creatine

cs3000

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Dietary Creatine as a Possible Novel Treatment for Crohn’s Ileitis

Some clinical trials are underway - case report just 1g of creatine enhanced gut health in a patient with ulcered ileitis / chohns

The patient also stopped his creatine. Over the following 4 months, the patient reported progressively more frequent and severe abdominal pain. A repeat colonoscopy at that time revealed worsening ileitis with more extensive ulceration.

Given this progressive ileitis, more intensive therapy was planned. Prior to initiating new agents, however, the patient requested a trial of his previous creatine hydrochloride supplement, as he felt his symptoms were better on the creatine supplement and worsened once it was stopped.
Upon stopping mesalamine and reinitiating creatine hydrochloride at 1,034 g/day, the patient reported a significant improvement in his symptoms. A repeat colonoscopy was performed 6 months later to assess endoscopic Crohn’s activity on “creatine monotherapy.” The prior extensive ulceration and inflammation in the TI appeared significantly improved, and only one, small aphthous ulcer was seen (Figure 3)


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145094/
2.2. Creatine Supplementation Regulates the Energy Balance of Intestinal Epithelial Cells, Epithelial Integrity and Barrier Function
cytosolic BB-CK is expressed in a HIF-2 dependent manner and that this enzyme localizes to apical intestinal epithelium cell adherence junctions, where it is critically involved in the ATP-dependent junction assembly, epithelial integrity and mucosal barrier function
Creatine Supplementation Maintains Intestinal Epithelial Energy Homeostasis and Protects against Colitis in Animal Models
Oral creatine supplementation in mice with experimentally induced colitis markedly ameliorated both disease severity and inflammation in TNBS and DSS mouse colitis models
2.5. A Genetic Screen with Mice Susceptible for Colitis Reveals a Link to Creatine Metabolism



creatine barrier function.png

Creatine helps to provide energy to some body tissues, such as the colon. In the colon, this energy allows cells to form a tight barrier between molecules in digested food and bacteria and the body's infection-fighting cells within the colon underneath this barrier. If the barrier becomes "leaky" molecules may pass through and lead to inflammation. This "leakiness" may contribute to the colon inflammation seen in ulcerative colitis.

both preclinical and clinical studies provide correlative evidence that energetic changes and dysregulation of the Cr/CK pathway are closely linked with the etiology of hypoxic and inflammatory disorders. Altered Cr metabolism by the gut microbiota may define an important influence on the human host creatine pathway

inhibition of CK markedly disrupts apical junction assembly and barrier integrity. Cytoskeletal and apical junction rearrangements that permit epithelial turnover and transepithelial transport are energy-dependent processes, and as such, structurally associated CK is poised to function as a conduit for rapid ATP generation in mucosal barrier dynamics

impaired Cr/PCr shuttling may contribute to dysregulated mitochondrial energetics and the increased barrier permeability characteristic of inflamed mucosae. Most notably, this work highlights the potential for Cr supplementation in IBD to promote epithelial restitution and ameliorate mucosal inflammation.

In hypoxic intestinal epithelial cells, cytosolic CK localizes to apical adherens junctions, providing a conduit for rapid ATP generation during the energy-dependent processes of epithelial junction assembly and barrier restitution
 
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